Neoadjuvant Triplet Immune Checkpoint Blockade in Newly Diagnosed Glioblastoma

This is the authors' abstract. We don't add key points for this paper.

Abstract Glioblastoma (GBM) is an aggressive primary brain tumor with a dismal prognosis. Given the paucity of tumor infiltrating lymphocytes (TILs), an immune suppressive tumor microenvironment and a low tumor mutation burden, the potential benefits of immune checkpoint inhibition (ICI) for GBM patients are considered low¹,². Anti-PD-1 ICI monotherapy administered post-primary resection or after recurrence has not improved GBM outcomes³,⁴. Here, we present the first case of newly diagnosed IDH-wildtype, MGMT-unmethylated GBM treated with upfront neoadjuvant triplet ICI (anti-PD-1/anti-CTLA4/anti-LAG3). Twelve days post-therapy, the primary resected GBM showed anti-PD-1-bound TILs and marked TIL infiltration and activation, compared with baseline biopsy. After 10 months, there is no recurrence.